Objective:To study the predictive value of the systemic immune inflammation index (SII) on the overall survival rate of patients after Whipple surgery for pancreatic ductal adenocarcinoma (PDAC).Methods:The clinical data of patients with PDAC who underwent Whipple surgery at the First Affiliated Hospital of Zhengzhou University from January 1, 2010 to December 31, 2017 were retrospectively analyzed, and the SII value was calculated. The best cut-off value of SII was 900, and all patients were divided into the low SII group (SII≤900) and the high SII group (SII>900) using 900 as the dividing point. The Kaplan-Meier method was used to draw survival curves and the log-rank test was used. The overall survival of the two groups of patients were analyzed. The Cox risk regression model was used to perform univariate analysis of the various clinicopathological parameters, and multivariate analysis for the statistically significant indicators.Results:Of 135 patients enrolled into this study, there were 78 males and 57 females, aged 28.0-76.0 (56.6±8.8) years. There were 92 patients in the low SII group, aged (56.9±9.2) years with 53 males and 39 females; and 43 patients in the high SII group, aged (56.1±7.9) years, with 25 males and 18 females. The median survival of the low SII group and the high SII group were 32.7 months (95% CI: 28.4-37.0) and 24.4 months (95% CI: 21.4-27.4), respectively. The survival of patients with PDAC in the low SII group was significantly higher than that in the high SII group ( P<0.05). On univariate survival analysis, postoperative overall survival of patients with PDAC was significantly associated with high SII ( HR=2.047, 95% CI: 1.354-3.096), R 1 margin ( HR=2.595, 95% CI: 1.663-4.048), a positive rate of lymph node>20% ( HR=3.244, 95% CI: 1.888-5.573), and positive regional lymph node (N1) ( HR=3.061, 95% CI: 1.993-4.702), all P<0.05. Multivariate Cox regression analysis showed that high SII ( HR=1.672, 95% CI: 1.094-2.555), R 1 resection margin ( HR=2.167, 95% CI: 1.274-3.685), and a positive rate of lymph node>20% ( HR=2.631, 95% CI: 1.309-5.285) to be independent risk factors affecting overall survival ( P<0.05). Conclusion:SII was an independent prognostic factor available before surgery for patients with PDAC. It has some guiding significance in predicting overall survival in patients after Whipple surgery for PDAC.

Objective To establish the risk assessment index system of clinical surgery department and determine the weight of each index,so as to provide reference for hospital performance management department.Methods Delphi method was used to construct the risk assessment index system of clinical surgery department,and the weight of each index was calculated by analytic hierarchy process.Results The risk assessment index system of clinical surgery departments was successfully constructed,including 4 first-level indicators,12 second-level indicators and 33 third-level indicators.Conclusion Clinical surgical department risk evaluation index system can more reasonably and fairly reflect the clinical risk borne by the surgical department,but also can more truly reflect the results of clinical department performance assessment,which is conducive to the reform of the hospital's internal performance appraisal and distribution system is more rational.

Objective To evaluate the application effect of the risk evaluation index system in clinical surgery departments.Methods A questionnaire was designed based on the risk evaluation index system of clinical surgery departments,and the risk evaluation were graded with RSR method.Results Among the risk evaluation of clinical surgery departments in the two hospitals,the results of first hospital were low,medium and high risk departments,and the results of second hospital were low and high risk departments,respectively.The differences among them were statistically significant.Conclusion In the process of clinical performance evaluation,it suggests that the hospital management department refer to the risk evaluation index system of clinical surgery departments as a risk assessment tool to promote more scientific and fairer performance distribution,which has certain social promotion value.